Reduction of Major Medical Expenses
Business challenge
The challenge for our client, a major healthcare solutions provider, is to identify individuals with a higher likelihood of incurring high medical costs. They also seek to identify the most important risk factors and recommend interventions to reduce these costs. Their motivation stems from the fact that 30% of all their costs are associated solely with 1% of their patients.
PRESAGE Solution
Presage has developed predictive models for significant medical expenses among groups of diabetic patients. By utilizing expense history, health records, and various socio-demographic and socio-economic factors, we can predict a patient’s cost and the probability of incurring a specific expense.
Presage’s solution gave a 25% improvement over the client’s current regression based modeling.
Benefits obtained
- Cost reduction by identifying in advance those patients who will generate the highest costs.
- Significant improvement in patient health and treatment outcomes has been observed.